The American Dilemma and How We Can Fix It

While I have read the ACA in its entirety I wished that I were dyslexic while going through that task.  It might have made more sense.  Unless I missed it there is not  yet a provision that those of us who have companion animals are required to provide health insurance for our pets.  That might be coming.

So when Gracie developed a hematoma near her right ear, I realized that I was going to have to pay to have this treated out of pocket.  My regular vet was on vacation and would not return for two weeks.  While this was not a life-threatening condition, I could tell that it bothered her as she shook her head regularly throughout the day and I wanted to get her treated as soon as possible.  And the hematoma was enlarging on a daily basis.

I took her to another animal hospital which is close to my home and which I had used from time to time for routine things such as updating vaccinations.  This facility is only about five minutes from  the house and, unlike my regular vet, is open seven days a week.  But I always get the impression when I go there that I am going to a place that is a business more than a healing practice.  It’s hard to describe the reason for that impression other than to say that perhaps having had the company of dogs all my life, perhaps I’ve picked up on some of their intuitive perceptions.

Gracie and I met with a young female vet who was extremely sweet and very nice.  She got on the floor to examine Gracie and obviously loved animals.  So far so good.  As I lost a dog years ago while under anesthesia I asked if they could treat the hematoma using a local and simply drain it.  She went to confer with the owner of the hospital and returned to tell me that they would indeed need to use a general anesthetic and remove any mass that might have formed at the base.  She also returned with an estimate of the costs.  Reluctantly, I resigned myself to going through the general anesthesia and treating the condition as they had suggested.

As I read through the estimate I noticed that she had included a charge for a teeth cleaning.  I pointed out to her that there was no need for that as I had Gracie’s teeth cleaned five months earlier.  She said, “Well, if you don’t do the cleaning ($65) the cost of the anesthetic ($32) will be “slightly higher.  We give you a break on the anesthesia with a cleaning because we try to encourage people to follow a regular oral regimen for their pets.”  The actual charge for the mass removal was $140.  I thought to myself, that seems like a reasonable fee – $140 plus (I figured for the “slightly higher” anesthesia at $50-$60), not too bad.

So I left Gracie at the vet and asked them to call me when they had finished the procedure.  The doctor called me promptly when the operation was finished to let me know that Gracie was doing fine, the operation was a success and I could pick her up after four o’clock that afternoon.

I arrived to pick up Gracie precisely at four and asked the reception for my bill so that I could settle it while the staff brought Gracie out from the back.  When I looked at the bill I was a little startled.  The mass removal was listed at $140 per the estimate, but the anesthesia had gone from $32 to $150.  My invoice came to $53 more than it would have been had I not only had the mass removed but had her teeth cleaned unnecessarily.  Naturally, I thought this was an error so I asked to speak with the vet who owns the hospital, but he had just left for the day.

So I gave the hospital a check for the balance – less $53 and said, “I’m going to pretend that you actually did Gracie’s teeth cleaning and pay you on the basis of the estimate.  Since you didn’t actually do a cleaning, I think that’s more than fair.  But please ask Doctor K. to call me tomorrow so that we can discuss it.”  Gracie and I then left.

I didn’t hear from the owner the next day or the next so I called to speak with him.  I was connected to the office manager.  I explained my view and asked her to confirm that the bill I paid, as adjusted, was satisfactory to the hospital.  She promised to call me back within a few days.  When I didn’t hear from her I called her back.  At that point she said that she had discussed it with the owner and they were going to give me a $50 credit for the anesthesia and that my balance was $3.

I said that I would like to speak to the owner directly and would do so a few days later when I brought Gracie in to have her stitches removed.

By that time I was feeling exasperated over this three dollar invoice and had decided just to pay it.  In fact, I brought 300 pennies with me in a paper bag to settle the account.  But when I went to reception and Gracie went to the back to have the stitches removed, I was informed by reception that I owed them $53.  I explained that the office manager had indicated that the hospital was going to issue a $50 credit and that my balance was only three dollars.  So they asked the owner to come out and speak with me.

Dr. K. came out and began our conversation with the statement, “I understand you have a problem.”  Given the strident way in which he made that statement, I truly understood how John Boehner must feel in dealing with Harry Reid and President Obama.  I replied, “No, actually I have a question.  And here it is.”

“Why is it that anesthesia and a mass removal costs $290 but anesthesia, a mass removal and a dental cleaning costs $237?  This reminds me a little of Obamacare where you pay more and get less.”  (That did elicit a smile from the vet).

Well, we finally agreed that my balance was only three dollars.  So I left my bag of pennies on the desk and Gracie and I went home.  I’m most grateful that she is doing well and the scar has almost completely healed. 

I am not the sort of person who simply alters invoices because I believe that the product or service provided was worth a lesser amount.  At least, I wouldn’t do that without offering the provider the opportunity to discuss the matter.  So the reason for this post is to solicit some input from my readers.

What are your thoughts on this situation.  Should I have paid the invoice just as rendered?  Should the vet have offered to accept the amount that I tendered as payment in full?  Or should he have made a reduction in the amount he charged since one of the services wasn’t provided?

I look forward to hearing from you.

P. S.  Isn’t this a pleasant change from all the politics that I’ve posted of late?


  1. The vet has a point re: teeth cleaning, I suppose. But why wouldn’t he structure it as providing free teeth cleaning (if desirable or necessary) while the dog is under. Seems like it would be easier for everybody.

    $3? Really? It’s ridiculous on his part, It cost him at least $10 to collect it plus losing the chance at a regular customer. Stupid on his part.

    You’ve more patience than I do, so good on you. 🙂

    • There’s a reason I can afford to be patient. There are a lot of other vereterinary choices available – including my regular vet whom I normally would have used. And, as I pointed out to a number of this vet’s clients whom I know from the dog park, they also have those choices. Everyone thought that this was at the least, “petty” and at worst, it sounded to one of his clients like “money grubbing.”

      • Pretty much my take as well. Apparently a cutthroat business out there. Him, not you, if there was any doubt. Here there’s traditionally a shortage, and the best vets mostly do large animals, in other words cows, and horses. Although they will take care of you but, tend to be not overly empathetic.

  2. It’s called creative accounting! You will see more of it in the future.

    • I think holding out for a three dollar balance when I should probably have gotten a reduction is called very short term thinking and a bad business plan. As it happens I mentioned this to a number of people at the dog park – all of whom are clients of this animal hospital. They were all shocked – and dismayed. I’m sure that they will be auditing their bills on their next visit.

  3. If you’re told what it is going to cost, why would they think you would do anything else?

    • Beats me. I guess it’s a matter of short-term thinking. There’s a lot of that going around. Thanks for taking your time to comment. I look forward to hearing from you again in the future.

  4. We found the same type of mentality when it came time to bury my mom. The mortuary/cemetery, which shall remain nameless,(but whose initials are F(orest) L(awn), offered us the package deals, which we declined on the basis of 1) Mom’s plot was prepaid, and 2) she specifically asked to have no services whatsoever. That meant no chapel, no complimentary floral tributes, no guestbook, no hearse, no somber greeters, etc. Somehow, though, the total bill came to more than their package rates. I guess that’s just creative bookkeeping.

    • I understand your situation with your mom. I encountered the same thing with mine. You were fortunate that she gave you instructions on how she wanted her burial to be conducted and that you held to those.

      Jessica Mitford wrote a scathing expose of the funeral industry, “The American Way of Death”, published in 1963.

      Perhaps the veterinary industry needs a companion book to be written about it.

  5. I’m glad you fought this nonsense and won!
    I’ve been hearing horror stories from my dear aunties up in in their little town in Canada about the price fixing amongst the vets there. My aunts have a penchant for adopting “hard-luck” case cats and it seems every few months they were being soaked for another several hundred dollars for something that seemed minor, no matter which vet they tried. I’ve had good luck with my vet(s) here in LA, but like you, we have a lot of local options. I am worried about the ever-increasing amount of health regulations resulting in increased costs across the board, however, including for vet care. A lot of the supplies are the same, and so the costs are bound to be impacted!

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